2021 Fall Sports Intent to Play Survey

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The Department of Health/PE/Athletics is planning for the upcoming Fall 2021 season. The completion of this form will provide necessary information regarding which students plan to participate in the 2021 Fall Sports season (Varsity, JV, and Modified). An updated physical exam will be required for all student athletes. Varsity/JV Sports begin on 8/23/21, therefore physicals must be dated after 8/23/20 & Modified Sports begin on 9/8/21, therefore physicals must be dated after 9/8/20. We encourage all student-athletes and their families to complete this survey as soon as possible and no later than June 1, 2021. If you have any questions regarding participation in the Fall 2021 season please call the Athletic Office at 845-647-0134.

Student First Name

Student Last Name

What grade are you CURRENTLY in?

Grade 6

Grade 7

Grade 8

Grade 9

Grade 10

Grade 11

Clear selection

Do you plan to participate in a FALL sport (football, field hockey, boys' and girls' soccer, cross country, girls' tennis, girls' volleyball and boys' golf)?

Yes

Clear selection

Which statement best explains your physical preference?

I have an up to date physical (dated after 8/23/2020 for JV/Varsity or after 9/8/2020 for Modified) on file at my doctor's office and will provide the school with a copy ASAP (Please fax to 647-0230)

I do not have an up to date physical on file at my doctor's office and/or will be due for a physical prior to 8/23/2021, and I will make an appointment to get one at my private doctor before Fall sports begin

I am interested in obtaining a school physical prior to fall sports

Clear selection

Submit

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